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In fact, some studies have even suggested the opposite

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Circulating IGF-I deficiency and GH hypersecretion induce insulin resistance which is further augmented by insufficient suppression of hepatic glucose output

In addition, there is a higher intensity of CD38 expression (measured by flow cytometry) in the more aggressive multi-hit variants, which allows further differentiation of the diseases and the use of CD38 as a biomarker for early diagnosis [14]

Our focus in 2026 is raising awareness of this educational tool and encouraging its use across the NHS